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目的探讨阿托伐他汀片联合维生素E治疗颈动脉斑块和内膜增厚的临床疗效及其机制。方法100例中老年颈动脉斑块患者随机分成对照组和观察组,对照组给予阿托伐他汀和拜阿司匹林肠溶片治疗;观察组在对照组治疗的基础上加用维生素E治疗,二组疗程均为6个月。彩色多普勒超声诊断仪检测颈动脉内膜中层厚度(CIMT)变化情况,同时检测患者治疗前后胆固醇、低密度脂蛋白和氧化应激参数(丙二醛和谷胱甘肽)的改变。结果观察组的颈动脉斑块和内膜增厚度改善明显优于对照组(P<0.05),总有效率为88%,明显高于对照组的68%,且二组均无明显不良反应。二组治疗后血脂均较治疗前明显降低,但是二组之间差异无统计学意义(P>0.05),观察组治疗后丙二醛(MDA)较治疗前明显降低(P<0.05),谷胱甘肽(GSH)较治疗前明显增高(P<0.05)。结论阿托伐他汀联合维生素E治疗颈动脉斑块和内膜增厚疗效确切,无明显不良反应,其治疗机制可能和改善体内的氧化应激状态有关。
Objective To investigate the clinical effects and mechanisms of atorvastatin tablets combined with vitamin E in the treatment of carotid artery plaque and intimal thickening. Methods 100 cases of middle-aged and elderly patients with carotid plaque were randomly divided into control group and observation group. The control group was given atorvastatin and aspirin enteric-coated tablets. The observation group was treated with vitamin E on the basis of the control group. The second group Course of treatment are 6 months. The changes of carotid intima-media thickness (CIMT) were detected by color Doppler sonography, and the changes of cholesterol, LDL and oxidative stress parameters (malondialdehyde and glutathione) before and after treatment were also measured. Results The improvement of carotid artery plaque and intimal thickening in the observation group was significantly better than that in the control group (P <0.05). The total effective rate was 88%, which was significantly higher than that of the control group (68%). There was no obvious adverse reactions in both groups. The blood lipid of the two groups after treatment was significantly lower than before treatment, but there was no significant difference between the two groups (P> 0.05). The malondialdehyde (MDA) in the observation group was significantly lower than that before treatment (P <0.05) GSH was significantly higher than before treatment (P <0.05). Conclusion Atorvastatin combined with vitamin E treatment of carotid plaque and endometrial thickening exact effect, no significant adverse reactions, and its mechanism may be related to improving the body’s oxidative stress.